Having tough conversations with family about medical care can ease burden on hospitals

There’s one tough conversation every family can have to ease the burden on hospitals during the coronavirus pandemic — deciding how far care should go when someone is critically ill and whether they should be intubated.

“One important thing that has come up among some of my friends, particularly those who work in the emergency room where they’re seeing people in critical stages (is) do we intubate or not, put somebody on a ventilator or not,” said Dr. Celine Gounder, an infectious diseases specialist, during a Johns Hopkins Bloomberg School of Public Health webinar Thursday.

Gounder, a Johns Hopkins alumna and member of President-elect Joe Biden’s COVID-19 advisory board, said in many cases, hospital workers have to decide what level of care critically-ill patients receive, because they haven’t had those conversations with their families.

“A lot of people do not have their affairs in order, they have not had these conversations with family.”

She said hospitals are already overworked, and having that decision already made saves health care workers not only time, but the stress that comes with those decisions.

“We’re rationing. That is the reality right now. And I think that is really traumatic for health care workers to have to be the ones making those decisions because families have not had these conversations,” Gounder said.

But the burden isn’t just on families to outline what care they want, according to Gounder.

“Something the public can do is have conversations about what they would want if they get critically ill,” she said.

“Secondly, there needs to be better guidance from not just the federal government, but really at the state and local level as well, as to what are crisis standards of care so that you’re not having to make this up on the fly.”

Gounder and Loyce Pace, both members of Biden’s COVID-19 advisory board, discussed the Biden administration’s plans to tackle the coronavirus from vaccine rollout to new treatments in the webinar.

The full, 30-minute video can be watched below:

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